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General NPI Number Information
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NPI Number | 1588696694
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Entity Type | Organization
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Legal Business Name | UROLOGY ASSOCIATES OF VERO BEACH LLC
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 02/14/2008
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Provider Practice Location Address
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Address Line | 3745 11TH CIR SUITE 103
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City | VERO BEACH
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State | FL
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Zip | 32960-4837
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Country | US
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Telephone | 772-794-9771
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Fax | 772-794-9773
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Provider Business Mailing Address
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Address Line | 3745 11TH CIR SUITE 103
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City | VERO BEACH
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State | FL
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Zip | 32960-4837
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Country | US
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Telephone | 772-794-9771
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Fax | 772-794-9773
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | CHRISTOPHER P TARDIF
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Credential | MD
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Telephone | 772-794-9771
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number |
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License Number State |
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